Genes as instruments for studying risk behavior effects: an application to maternal smoking and orofacial clefts

George Wehby; Astanand Jugessur; Jeffrey Murray; Lina Moreno; Allen Wilcox; Rolv Lie

doi:10.1007/s10742-011-0071-9

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Genes as instruments for studying risk behavior effects: an application to maternal smoking and orofacial clefts

Journal article

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Genes as instruments for studying risk behavior effects: an application to maternal smoking and orofacial clefts

George Wehby, Astanand Jugessur, Jeffrey Murray, Lina Moreno, Allen Wilcox and Rolv Lie

Health services and outcomes research methodology, Vol.11(1), pp.54-78

07/2011

DOI: 10.1007/s10742-011-0071-9

PMCID: PMC3216039

PMID: 22102793

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https://www.ncbi.nlm.nih.gov/pmc/articles/3216039View

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Abstract

This study uses instrumental variable (IV) models with genetic instruments to assess the effects of maternal smoking on the child’s risk of orofacial clefts (OFC), a common birth defect. The study uses genotypic variants in neurotransmitter and detoxification genes relateded to smoking as instruments for cigarette smoking before and during pregnancy. Conditional maximum likelihood and two-stage IV probit models are used to estimate the IV model. The data are from a population-level sample of affected and unaffected children in Norway. The selected genetic instruments generally fit the IV assumptions but may be considered “weak” in predicting cigarette smoking. We find that smoking before and during pregnancy increases OFC risk substantially under the IV model (by about 4–5 times at the sample average smoking rate). This effect is greater than that found with classical analytic models. This may be because the usual models are not able to consider self-selection into smoking based on unobserved confounders, or it may to some degree reflect limitations of the instruments. Inference based on weak-instrument robust confidence bounds is consistent with standard inference. Genetic instruments may provide a valuable approach to estimate the “causal” effects of risk behaviors with genetic-predisposing factors (such as smoking) on health and socioeconomic outcomes.

Health Administration

Economics general

Medicine & Public Health

Genetic instrumental variables

Oral clefts

Child health

Methodology of the Social Sciences

Birth defects

Statistics, general

Public Health/Gesundheitswesen

Mendelian randomization

Smoking

Details

Title: Subtitle: Genes as instruments for studying risk behavior effects: an application to maternal smoking and orofacial clefts
Creators: George Wehby - Department of Health Management and Policy College of Public Health, University of Iowa 200 Hawkins Drive E205 GH Iowa City IA 52242 USA
Astanand Jugessur - Norwegian Institute of Public Health Oslo Norway
Jeffrey Murray - University of Iowa Iowa City Iowa USA
Lina Moreno - University of Iowa Iowa City Iowa USA
Allen Wilcox - National Institute of Environmental Health Sciences Research Triangle Park Durham NC USA
Rolv Lie - University of Bergen Bergen Norway
Resource Type: Journal article
Publication Details: Health services and outcomes research methodology, Vol.11(1), pp.54-78
DOI: 10.1007/s10742-011-0071-9
PMID: 22102793
PMCID: PMC3216039
NLM abbreviation: Health Serv Outcomes Res Methodol
ISSN: 1387-3741
eISSN: 1572-9400
Publisher: Springer US; Boston
Language: English
Date published: 07/2011
Academic Unit: Preventive and Community Dentistry; Orthodontics; Anatomy and Cell Biology; Health Management and Policy; Stead Family Department of Pediatrics; Epidemiology; Economics; Pediatric Dentistry; Craniofacial Anomalies Research Center; Public Policy Center (Archive); Dental Research
Record Identifier: 9984025446802771

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